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<title>新增回饋金報表明細</title>
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<div>
  <div align="center">
    <table width="538" height="206" border="0" cellpadding="1" cellspacing="2" bgcolor="#ADADAD">
      <tr>
        <td height="38" colspan="2" align="left"><div align="center"><font color="#ffffff"></font>回饋金明細</div></td>
        </tr>
      <tr>
        <td width="133" height="20" align="left" bgcolor="#FFFFFF"><div align="right">簽約單位：</div></td>
        <td width="395" align="left" bgcolor="#FFFFFF"><label>
          <input name="title" type="text" id="gold_Unit" size="30" />
        </label></td>
        </tr>
      <tr>
        <td height="20" align="left" bgcolor="#FFFFFF"><div align="right">期刊名稱：</div></td>
        <td align="left" bgcolor="#FFFFFF"><label>
          <input name="name" type="text" id="gold_Name" size="30" />
        </label></td>
        </tr>
      <tr>
        <td height="20" align="left" bgcolor="#FFFFFF"><div align="right">授權篇數(今年)：</div></td>
        <td align="left" bgcolor="#FFFFFF"><label>
          <input name="name" type="text" id="gold_Nub" size="30" />
         </label></td>
      </tr>
      <tr>
        <td height="20" align="left" bgcolor="#FFFFFF"><div align="right">過刊回饋金：</div></td>
        <td align="left" bgcolor="#FFFFFF"><label>
          <input name="name" type="text" id="gold_Out" size="30" />
        </label></td>
        </tr>
      <tr>
        <td height="20" align="left" bgcolor="#FFFFFF"><div align="right">現刊回饋金：</div></td>
        <td align="left" bgcolor="#FFFFFF"><label>
          <input name="name" type="text" id="gold_In" size="30" />
        </label></td>
        </tr>
      <tr>
        <td height="20" align="left" bgcolor="#FFFFFF"><div align="right">總回饋金：</div></td>
        <td align="left" bgcolor="#FFFFFF"><label>
          <input name="name" type="text" id="gold_Add" size="30" />
        </label></td>
        </tr>
      
  </table>
  </div>
  
</div>
<div align="center">
  <input type="submit" name="btn_gold_save" id="btn_gold_save" value="儲存" />
  <input type="submit" name="btn_gold_clear" id="btn_gold_clear" value="清除" />
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